Seeing an Allergist

Why an allergist? Allergists are medical specialists who treat allergic diseases and related conditions. These include asthma, hay fever, sinusitis, rashes, hives and certain kinds of reactions to foods, insect stings and drugs.

Every board-certified allergist first completes specialty training in either internal medical or pediatrics, and then completes an additional training program of two or more years studying the diagnosis and treatment of allergic and related diseases. Certification by the American Board of Allergy and Immunology requires not only approved training, but also successful completion of a challenging written examination. Every board-certified allergist thus has credentials in at least two specialties.

Although any physician may treat allergic diseases, the board-certified allergist-immunologist has the advanced training and experience in the techniques of determining what is causing an allergic reaction and how best to solve the problem.

Step 1: Consultation

Your first step is to see an allergist-immunologist. You may need to be sent by your primary care physician. Some health plans and HMOs require authorization for referral. If your request is not immediately honored, ask again and be firm.

Step 2: Testing

The allergist will obtain a detailed medical history, examine you and evaluate your symptoms. Tests (perhaps lung function tests or x-rays) will be performed to define the nature of your allergic disease. Skin tests or allergy blood tests may be needed to define the precise causes of your allergic symptoms. Based on the entire clinical evaluation, a diagnosis is made.

If the allergy tests are negative, despite good control reactions, do not despair. Allergists are also experts in the treatment of nonallergic asthma, rhinitis, and other types of reactions.

Step 3: Treatment

This is the step where your allergic symptoms and you get better. Allergy treatments are of three types: Prevention. Medication. Immunotherapy.

Prevention. Often the cause of the symptoms can be avoided or removed from your life. For example, a particular food can be avoided, or a pet can be removed from the home or kept away from sleeping areas.

Some causes of symptoms, such as pollen, molds and dust mites, cannot be eliminated. Exposure can be reduced, however, by environmental control measures prescribed by your allergist.

Medication. Although prevention comes first, more may be needed. Medications frequently are used to decrease or eliminate allergy symptoms and return patients to good health. Recent advances in medications for asthma and other allergic diseases have been phenomenal. Improvements in drugs have eliminated most of the old side effects.

The allergy specialist is knowledgeable in the latest safe and effective medications for treating allergic illness.

Immunotherapy ("allergy shots"). If medications are not sufficient to restore health, the allergic symptoms may be controlled or eliminated with allergy shots.

Allergy shots have been used since 1911. This time-tested therapy decreases a patient's sensitivity by introducing increasingly larger doses of the substances to which the patient is allergic. The treatment is a method for increasing the allergic patient's natural resistance to the things that are triggering the allergic reactions.

The immunization procedure begins with injections of small amounts of purified "extracts" of the substances that are causing allergic reactions. For example, the extracts may be derived from pollens, mold spores, animal dander, dust mites or insect venom. They are approved for this use by the U.S. Food and Drug Administration, and over the years they have been improved considerably.

Allergy shots stimulate the immune system to fight allergies safely, effectively and naturally. Beginning with small doses and increasing them gradually on a weekly or biweekly basis, the therapy continues until a maintenance level is achieved. Then, a maintenance dose is injected every few weeks.

Immunity does not occur immediately, but patients do begin to feel better quickly. In some patients, immunity is maintained and treatment can be discontinued after several years. For others, treatment may be needed for longer periods of time.

With the immune system restored to good health, few or no medications may be needed. Work or school days are no longer missed. The burden of allergies is lifted, and allergies become something you just don't think about any more.

Candidates for immunotherapy include patients of all ages. Pregnant patients should continue treatment started prior to pregnancy.

Allergy shots are always given under medical supervision at a location where medical staff and medications are available to handle any serious reaction. Although rare, systemic reactions can occur for allergy shots because the treatment involves the substances to which the patient is known to be allergic.

The Future

Researchers are now studying ways to go beyond today's treatments. We soon may have ways to block the body's allergic response by reducing or inhibiting the release of histamines and other chemicals that cause allergic reactions.

When these treatments become available, you can be certain that allergists-immunologists will be at the forefront of their use.

But you don't have to wait for the future. Today, you can put the misery of allergies out of your life with the help of an allergist.